Healthcare Provider Details

I. General information

NPI: 1083773204
Provider Name (Legal Business Name): PROFESSIONAL PASTORAL- COUNSELING INST. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8035 HOSBROOK RD STE 300
CINCINNATI OH
45236-2951
US

IV. Provider business mailing address

8035 HOSBROOK RD STE 300
CINCINNATI OH
45236-2951
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-5990
  • Fax: 513-792-3308
Mailing address:
  • Phone: 513-791-5990
  • Fax: 513-792-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberE3055
License Number StateOH

VIII. Authorized Official

Name: MR. RICHARD DONNENWIRTH
Title or Position: CLINICAL DIRECTOR
Credential: PCC
Phone: 513-791-5990